Provider Demographics
NPI:1114452240
Name:RUGG WELLNESS, PC
Entity Type:Organization
Organization Name:RUGG WELLNESS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:RUGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-755-4966
Mailing Address - Street 1:26 OTSEGO RD
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-1736
Mailing Address - Country:US
Mailing Address - Phone:508-887-5054
Mailing Address - Fax:508-519-2451
Practice Address - Street 1:26 OTSEGO RD
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-1736
Practice Address - Country:US
Practice Address - Phone:508-887-5054
Practice Address - Fax:508-519-2451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA51823207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty